Korean Journal of Nephrology 2007;26(3):334-341.
The Stability of Peritoneal Dialysis for the Treatment of Chronic Renal Failure in Cirrhotic Patients Acompanying Ascites
JungIn Kim, M.D.1, JungEun Lee, M.D.1, HyunJeong Baek, M.D.2, SungChul Choi, M.D.1 JungHo Do, M.D.1, Wooseong Huh, M.D.1, YoonGoo Kim, M.D.1, DaeJoong Kim, M.D.1 and HaYoung Oh, M.D.1
Division of Nephrology, Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine1 Kangwon National University School of Medicine2 Seoul, Korea
복수가 동반된 간경변증을 가진 말기 신부전 환자에서 복막투석의 안정성
김정인1 이정은1 백현정2 최성철1 도정호1 허우성1 김윤구1 김대중1 오하영1
성균관대학교 의과대학 삼성서울병원 내과1, 강원대학교 내과2
Abstract
Purpose : When liver cirrhosis patients accompanying ascites need renal replacement therapy because of chronic renal failure (CRF), peritoneal dialysis (PD) can allow direct removal of ascites and prevent anticoagulants use. However, since PD might aggravate hypoalbuminemia and increase chances of peritonitis, clinicians tend to hesitate to apply it to those patients. The aim of the present study is to assess the outcome and stability of PD for the treatment of CRF patient with cirrhosis accompanying ascites. Methods : A retrospective study based on the clinical records was performed in cirrhotic patients with ascites in whom PD was performed for the treatment of CRF and who were followed up at Samsung Medical Center unit, between January 1995 and July 2005. Results : In our study, 15 patients were enrolled. Child-pugh class was worse in non-survival group than survival group (p<0.01). One-year patient survival was 40% in Class C and 75% in Class B, and patient survival differed between Class C and Class B (p=0.0014). Causes of death were terminal liver failure (n=6) and sepsis due to pneumonia (n=1). Total 27 episodes of peritonitis occurred, and the peritonitis rates were 0.91 episodes/patients-year. Conclusion : Although the peritonitis rates turned out somewhat high, the use of PD for the treatment of CRF in patients with liver cirrhosis accompanying ascites seems to be safe and effective. Main cause of death in our study seems to be related to liver disease.
Key Words: Peritoneal dialysis (PD), Chronic renal failure (CRF), Liver cirrhosis, Ascites


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